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Transthoracic echocardiography (TTE) is an integral part of cardiologic outpatient (pts) assessment. The newest generation of pocket-size ultra-portable ultrasound devices (POCKET) enables bedside TTE with 2D imaging and colour-Doppler. The aim of the present study was to evaluate the diagnostic value of POCKET in cardiologic pts.Methods: 46 consec. pts were scanned with POCKET during physical examination. 6 pts (13%) were excluded due to poor image quality. The remaining 40 pts (35 male, age 58.5 years) were compared to routine high-end TTE. All exams were performed blinded. Target parameters were global left-ventricular function (LVF, normal, mild-, moderately-, severely-impaired), presence of hypertrophy (yes/no), regional or diffuse wall motion abnormalities (RWMA, DWMA), right ventricular (RV) and/or atrial dilatation and presence of valvular regurgitation (REGURG). Results: 100% concordance was found in semi-quantitative assessment of LVF, RV size, identification of LV hypertrophy and DWMA. Good concordance (>95%) was found for identification of atrial dilatation und any significant (>trace) REGURG. RWMA were correctly identified by POCKET with a sensitivity of 78% (95%CI 0,4-0,98) and a specificity of 100% (95% CI 0,89-1).Conclusion: Ultra-portable POCKET echo permits reliable and quick assessment of basic TTE parameters such as global LVF and cavity dilatation. Largest differences were found for identification of RWMA. REGURG can be well identified by POCKET, however a true quantitative assessment of REGURG severity is not possible due to the lack of spectral Doppler. A POCKET exam does not replace the standard echocardiographic exam, but provides a rapid bedside pre-assessment which may help to improve patient management and to optimize the individual diagnostic work-flow.